Practice &Training

Substance Use Criteria for HCV Treatment in Medicaid

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Provider Behavior

Medicare has accelerated its commitment to orthopedic bundled payment, but hospitals need guidance on how to succeed under new programs. We describe how bundled payment at one institution was associated with hospital savings and reduced Medicare payments. READ MORE

Facing constrained budgets, most state Medicaid programs adopted prior authorization criteria for sofosbuvir, an expensive but effective treatment for hepatitis C. Despite the potential cost savings associated with strict behavioral criteria, they raise troubling questions in terms of public health as well as medical ethics, clinical evidence, and potentially federal law. READ MORE